Positive and Negative Symptoms in Psychosis: Description, Research, and Future Directions

By Philip D. Harvey; Elaine E. Walker | Go to book overview
2. We may compare any measurable attributes of patients' utterances (syntax or content), with those of other groups who use the language, i.e., normal speakers, patients with other diagnoses, children, and so forth. This strategy may commence with the limitation that any differences that are found will be subject to the usual constraints of post hoc analysis. However, this becomes less of a problem if the attributes that are being quantified and compared have been suggested a priori from clinical observation, or have been deduced from formal models of the psychopathology concerned.
3. Neither of the foregoing have any necessary relationship to the reaction of a listener (or reader) to the utterances that are being analysed. These reactions may be the focus of a different kind of analysis that employs the method of rating. Ratings may be made on general aspects of the utterance - such as coherent/incoherent, or, more narrowly, along axes that have a traditional clinical definition, such as derailment, illogicality, poverty of thought and the like.
4. Ratings of the kind just mentioned may be treated as an independent variable, the strategy of analysis being directed at establishing correlations between rated attributes (i.e., listeners' reactions), and quantified measures of the utterances themselves regardless of diagnosis.
5. All of the foregoing may be extended to apply to larger units of utterance, such as is the case in discourse analysis.

On the Problem of Circularity in Language Disorders:

Diagnoses are made with significant reference to the verbal behavior of patients. Hence, when we compare different diagnostic groups and find quantifiable differences in their patterns of utterances, we may be merely finding that the verbal behaviors that form part of the diagnostic criteria for the disorder have influenced the diagnostician as they should. We may "discover" DSM III.

Dangerous circularity can be avoided by two strategies. The most powerful is to seek to establish reliable correlations between measured attributes of utterance and measured attributes of nonverbal behavioral deficits - e.g., motor clumsiness, anhedonia, response to medication, and the like. The second strategy looks for quantifiable aspects of verbal behavior that do not form part of the diagnostic criteria as correlates of the diagnosis.


Models of Language Anomaly

Psychopathologists have sought to explain the origin of

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